AB0665 Turkish validation of the ‘Cochin (Duruoz) hand function scale’ in patients with systemic sclerosis
Authors: A. Komac, D. Temiz Karadağ, E. Basaran, A. Yazici, A. Cefle
Journal: Annals of the Rheumatic Diseases (2022)

Background Hand impairment is the main challenge for patients with systemic sclerosis (SSc) and may arise from inflammatory arthritis, joint contractures, tendon friction rubs (TFRs), Raynaud’s phenomenon (RP), digital ulcers (DU), puffy hands, skin sclerosis, acro-osteolysis, or calcinosis. There is not yet a tool which can objectively measure hand functions in scleroderma patients both in daily practice and for research purposes. Objectives To adapt and validate the Turkish version of Cochin (Duruoz) hand function scale (CHFS) and contribute to the development of outcome measures with good metric properties assessing hand disability in SSc (1). Methods Ninety one consecutive patients who fulfilled the 2013 ACR/EULAR SSc classification criteria for SSc were enrolled in the study. Disease related involvements and physical examination findings of the patients were recorded. Participants filled out the self-administered questionnaire of the Turkish version of the CHFS. Modified Rodnan skin scores of the patients were calculated, bilateral hand extension and fingertip-palm distances were measured, grip strength was evaluated with hydrolic hand dynamometer. We evaluated convergent validity by testing the correlation between CHFS and related components of Short Form 36 version 2 (SF-36v2) and Scleroderma Health Assessment Questionnaire (sHAQ). Discriminant validity was evaluated by stratifying patients according to hand related involvements and disease subtypes. Thirty of the patients re-filled the CHFS questionnaire two weeks after the first visit. Results Demographic data and disease characteristics of the patients shown in Table 1. For the convergent validity, the CHFS significantly correlated with the sHAQ, Raynaud visual analog scale (VAS), digital ulser VAS, overall disease severity VAS, hand grip, hand extension measurements and fingertip-palm distances (Table 2). The instruments could discriminate between disease subtypes (10[0-24] / 2[0-19], p=0,038) and between the patients with and without contractures (11[0-24] / 2[0-9], p=0,023) for the discriminant validity. We demonstrated high reproducibility for CHFS (ICC = 0,894, 95% confidence interval = 0,779-0,949). Table 1. Demographic data and disease characteristics of the patients Age (years) 55.4±10.7 Total mRSS 6 ±5.1 Sex (female) 79 (%86.8) Right hand total mRSS 2.2±1.7 Diseasesubtype (diffuse) 25(%27.5) Left hand total mRSS 2.2±1.7 PAH 6 (%6.7) Right hand fingertip-palm distance (cm) 1.3±1 ILD 41 (%45.6) Left hand fingertip-palm distance (cm) 1.2±1.2 ANA positivity 88 (%96.7) Right hand extension (cm) 17.7±2.5 Arthritis 1 (%1.1) Left hand extension (cm) 18±2.3 Sclerodactly 79 (%86.8) Right hand hydrolic dynomometer pressure (kg) 21.7±8.6 Contracture 26 (%28.6) Left hand hydrolic dynomometer pressure (kg) 20.4±7.6 Amputation 12 (%13.2) SF 36 physical function 51.7 ±24 Active digitalulcer 3 (%3.2) SF 36 role limitations due to physical health 52±42 Digitalulcerscar 23 (%25.3) SF 36 role limitations due to emotional problems 57.3±33.4 Calcinosis 10 (%11) SF 36 energy/fatigue 46±23.3 CHFS score 3 [0-13] SF 36 emotional well-being 60.4±21.2 Raynaud’s phenomenon VAS 0.8±0.9 SF 36 social functioning 70±26 Digital ulcer VAS 0.5±0.9 SF 36 pain 64±30 Overall disease severity VAS 0.9±0.9 SF 36 general health 44.3±21.7 PAH: Pulmoner arterial hypertension, ILD: Interstitial lung disease, ANA: Anti nuclear antibody, CHFS: Cochin hand function scale, mRSS: Modified Rodnan skin score, VAS: visual analog scale, SF36: short form 36 Conclusion The Turkish version of the CHFS met the requirements of validity and reproducibility. With this study, we validated a scale which will contribute to the development of outcome measures with good metric properties assessing hand disability, disease evolution and treatment efficacy in our SSc patients. References [1]Duruöz MT, Poiraudeau S, Fermanian J, et al. Development andvalidationof a rheumatoid hand functional disability scale that assesses functional handicap. J Rheumatol . 1996;23(7):1167-1172. Disclosure of Interests None declared